FDA Adverse Event Summary report: N

MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

MDR report key: 3121095 · Received May 20, 2013

Report

Report Number
1531186-2013-02148
Date Received
May 20, 2013
Date of Event
April 24, 2013
Report Date
April 24, 2013
Manufacturer
C.T.M. HOMECARE PRODUCT, INC
Product Code
INI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES THROTTLE ASSEMBLY MOVES ON ITS OWN AND GETTING SIX FLASH CODE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
222743 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. HOMECARE PRODUCT, INC LEO-4S

Patients

Seq Age Sex Outcome Treatment
1 Other